Results of Surgical Management of Malignant Obstruction of the Common Bile Duct in Yaoundé

Introduction: In Cameroon, surgery remains the only approach in malignant obstructions of the common bile duct (MOCBD) even in palliative situations. The aim of this work was to describe the modalities of surgical treatment of MOCBD, evaluate the results and detect the factors associated with postoperative morbidity and mortality. Patients and Methods: We conducted an analytical observational study, with retrospective data collection from the files of patients operated upon for MOCBD. This was done in four referral hospitals in the city of Yaoundé for a 42-month period spanning from January 1, 2020 to June 30, 2023. Demographic data, clinical presentation, surgical data, and 30-day postoperative outcomes were collected. Results: We collected 71 files. The sex ratio was 1.4 and the mean age was 56 ± 11 years. Fifty-three (53) patients (74.6%) were overweight or obese and 10 patients (14.1%) were hypertensive. A clinical cholestasis syndrome was present in 69 patients (97.2%). Fifty-five (55) patients (77.5%) had a cancer of the head of the pancreas, 8 patients (11.3%) had an extra-hepatic cholangiocarcinoma and 8 patients (11.3%) had an ampullary adenocarcinoma. Eight (8) resections (11.3%) with curative intent had been carried out and in 63 cases (88.7%), surgery was palliative. Postoperative morbidity was 55.7%, influenced by advanced WHO stage (p = 0.02). Postoperative mortality was 25.7%, associated with a high ASA score (p = 0.01). Conclusion: Pancreatic head cancer is the main etiology of malignant obstructions of the common bile duct in Cameroon. Surgical treatment is most often palliative. Postoperative morbidity and mortality are high, influenced by high WHO and ASA scores.

Effect of thermal treatment on the swelling and surface roughness of common alder and wych elm wood

Wood heat treatment has increased signifi- cantly in recent years and is still growing as an industrial process to improve some wood properties. We studied the change of swellingand surface roughness of common alder （Alnus glutinosa （L.） Gaertn. ssp.glutinosa） and wych elm （Ulmus glabra Huds.） woods after heat treatment at two different temperatures and durations. The temperatures were 180 and 200 ℃ and the durations were 2 and 4 h. A stylus method was employed to evaluate the surface char- acteristics of the samples. Roughness measurements by the stylus method were made in the direction perpendicular to the fiber on the wood surface. Four main roughness parameters, mean arithmetic deviation of profile （Ra）, mean peak-to-valley height （Rz）, root mean square roughness （Rq）, and maximum roughness （Ry） were used to evaluate the effect of heat treatment on the surface characteristics of the specimens. Swelling and surface roughness parameters （Ra, Rz, Ry, and Rq） differed significantly for two temper- atures and two durations of heat treatment. Swelling and surface roughness values decreased with increasing treat- ment temperature and treatment times.

Common effluent treatment plant(CETP):Reliability analysis and performance evaluation

Common effluent treatment plants(CETPs) have been installed and are in operation at numerous industrial clusters throughout India. They serve to reduce effluent treatment cost, provide better collective treatment, and reduce land cost for small-scale industrial facilities that cannot afford individual treatment plants. Optimum working conditions for treatment of effluent to be at par with discharge standards is a major mandate for any CETP. In this study, the reliability and removal efficiencies(REs) of a CETP in the industrial area of Maharashtra State in India were examined. An established methodology was adopted to determine the effectiveness of the CETP in terms of biochemical oxygen demand(BOD), chemical oxygen demand(COD), total suspended solids(TSS), and oil and grease(O&G) concentrations. The CETP's compliance with respect to design standards and its operation were studied in detail. This paper highlights the results of RE and the coefficient of determination(R2) values obtained from the CETP data, estimates the pollutants removed at the highest and lowest rates over a period of time, and highlights the reasons for problem areas along with remedial measures. It was observed that, except O&G, all the parameters(BOD, COD, and TSS)showed fluctuations in removal efficiencies and their reliabilities. This situation can be improved by releasing effluent containing hydraulic and organic loading to the CETP as per standards and optimizing treatment processes, especially primary clari-flocculators and aeration tanks, both of which are important units of any CETP.

Identification and Treatment of Swine Influenza and Common Cold in Veterinary Clinic

[Objective] The paper was to investigate the differentiation and treatment of swine influenza and common cold in veterinary clinic.[Method] The clinical data of diseased pigs from May 2017 to May 2018 were analyzed retrospectively to explore the clinical treatment methods for swine influenza and common cold, and the effectiveness and accuracy of clinical diagnosis was further improved. [Result] Through in-depth analysis of test results, we obtained a comprehensive understanding of the main causes of swine influenza and common cold, and found that the causes in-cluded improper breeding management of pigs, nutrition of pigs and lack of immunity of newborn pigs. [Conclusion] Analysis of the causes of swine influenza and common cold and suggestion of targeted clinical treatment measures will reduce the incidence of swine disease, and promote the vet-erinary clinical treatment effect of swine influenza and common cold.

Efficacy of a Novel Antibody TLR3 Modulator in the Self-Treatment of Common Cold: The ESTUAR Trial

Context: Since the discovery of toll-like receptor 3 (TLR3), no specific tools have been developed to modulate its activity in upper respiratory tract viral infections (URTIs). ContafluTM (antibodies to TLR3 cytoplasmic fragment) is the first specific TLR3 modulator that showed efficacy in a mouse model of influenza. Objective: To evaluate the efficacy of Contaflu in URTI. Methods: A double-blind randomized placebo-controlled trial in adults with self-reported URTI (the ESTUAR trial) was conducted in 2012/2013 in Belgium. Adult outpatients started a 7-day treatment course with oral tablets of Contaflu or placebo within 36 h after onset of at least one of 4 typical symptoms of URTI. Patients were examined twice by their general practitioners, on days 2-3 and 10-14 after start of treatment. The primary endpoint was the overall severity of URTI calculated as the sum of Wisconsin Upper Respiratory Symptom Survey (WURSS-21) scores over the follow-up. Independent Student’s t test was used to compare the disease severity between groups. Results: A total of 243 patients were enrolled by 32 investigators (121 Contaflu, 122 placebo);92% of cases matched ICD codes J00 or J06. Most patients had very mild (41.8%) or mild (18.2%) URTI symptoms. In the ITT cohort, neither primary nor secondary outcome measures (duration of URTI, day-to-day and overall functional impairments) showed statistically significant differences between groups. The rate of adverse events was similar in both groups. In patients with moderate to severe URTI symptoms, Contaflu tended to reduce the overall disease severity, daily symptoms, and to improve the functional state. Due to the small size of the corresponding subgroups, Contaflu efficacy on daily scores was statistically significant (p < 0.05) only 1, 2, and 5 days after start of treatment. Conclusion: Contaflu was ineffective in mild URTI and showed efficacy in moderate to severe URTI cases.

Open surgical treatment for rare epithelioid hemangioendothelioma of the common femoral vein

Epithelioid hemangioendothelioma is a very rare disease affecting big blood vessels,especially veins.There have been very few articles describing the disease.We hereby present the case of a 56-year-old woman presenting with lower limb edema,who was initially being treated for residual thrombus in the common femoral vein but was eventually diagnosed with epithelioid hemangioendothelioma(EHE).The common femoral vein was resected and reconstructed using the external jugular vein.No additional therapy was administered.In this article,previous literature about EHE has been reviewed and oncologic principles have been discussed.

Analysis of Common Diseases and Construction Treatment Technologies of Road and Bridge Engineering

In recent years, the rapid growth of the number of private cars has greatly increased the traffic pressure, so the quality of roads and bridges should be further improved. The paper expounds the related matters of road and bridge engineering from three aspects. Firstly, it expounds the construction principles of road and bridge engineering, which are regarded as the theoretical basis of follow-up research. Secondly, it analyzes the common diseases of road and bridge engineering, including bridgehead damage, rein-forcement corrosion, and subgrade uneven settlement, etc. Finally, it puts forward the construction treatment technology of road and bridge engineering on the basis of the construction principles and taking the common diseases as reference.

我国海运碳排放市场机制构建的进路统筹

海运碳减排需要统筹运用包括市场机制在内的多种措施。欧盟推进单边海运碳排放交易机制虽然对市场机制在海运领域的运用具有正向推进价值,但基于其制度对共同但有区别责任原则的忽视等原因,与我国的航运利益并不相符。我国应当联合其他非欧盟国家反对欧盟的单边措施,并积极推进国际海事组织(IMO)层面多边海运碳排放市场机制的构建,推动海运碳排放真正实现公正公平的过渡。同时,在国内层面,基于国际国内统筹推进的整体要求,我国需要厘定基于国内立法的海运碳排放市场措施及其实施路径,构建相应的制度保障。

桥梁工程常见病害及施工处理技术

随着社会经济的快速发展,人们对路桥工程的施工质量提出了许多要求。为了满足社会的需要,施工单位应确保路桥运营的质量和效率,不断提高施工管理水平。同时,应针对不同种类的疾病制定科学的治疗策略,以减少道路和桥梁的严重疾病。基于路桥常见病治理的重要性,对路桥施工过程中的常见病进行探讨,并在此基础上提出相关的施工治理技术。

超干处理对菜豆种子活力及生理生化活性的影响

本研究旨在应用硅胶干燥的方法对菜豆进行超干处理,分析其主要生理活性相关指标,以期为菜豆种子的长期储藏提供科学依据和实践参考。超干处理后,应用考马斯亮蓝G-250染色法、TTC法、硫代巴比妥酸(TBA)法等测定蛋白质含量、脱氢酶(ADH)含量等指标。结果表明‘将军’含水量在6.95%时,种子活力及生理指标均高于对照,而抗氧化酶的活性显著低于对照;‘紫冠’含水量在6.89%时,各项生理指标均高于对照,O2-含量下降;‘热那亚’含水量在6.15%时,发芽率最高,蛋白含量、ADH活性明显上升,O2-含量、MDA不显著。这表明适度超干处理对‘将军’种子影响较大,对‘紫冠’、和‘热那亚’影响较小或者没有影响。通过试验结果可知,超干处理对于保存菜豆种子是可行的,为菜豆种子的长期储藏奠定下基础。

普通胃管联合肠梗阻导管治疗复杂性肠梗阻的效果

目的探讨普通胃管联合肠梗阻导管治疗复杂性肠梗阻的临床应用效果。方法选取2020年12月至2023年6月郴州市第一人民医院胃肠外科收治的54例复杂性肠梗阻患者作为研究对象,根据采用干预措施的不同分为研究组30例和对照组24例,研究组采用普通胃管联合肠梗阻导管治疗,对照组采用肠梗阻导管治疗;比较两组患者肠梗阻缓解时间、中转手术率、并发症发生率、住院时间、住院费用。结果研究组患者治疗有效率高于对照组,差异有统计学意义(P<0.05)。研究组患者的肠梗阻缓解时间、住院时间均短于对照组,住院费用少于对照组,差异有统计学意义(P<0.05)。两组患者在中转手术率、并发症发生率比较,差异无统计学意义(P>0.05)。结论普通胃管联合肠梗阻导管治疗效果优于单纯肠梗阻导管治疗效果,可明显改善肠梗阻症状,缩短住院时间,降低住院费用,减轻患者经济负担。

胆总管结石的影像学诊断应用现状及治疗研究

胆总管结石(CBDS)是指位于胆总管内的结石,分别为原发于胆总管内的结石和由胆囊或肝内胆管排出后进入并嵌顿于胆总管内的结石。CBDS是临床上常见的胆道疾病之一,患者临床症状为皮肤或巩膜黄染、上腹部绞痛、发热等。随着CBDS患病率和患者就诊需求的不断升高,医生及患者对于诊疗方式有了更高的要求,都希望得到更加快速、更加有效的诊疗方案。影像技术及内镜技术的进步为CBDS疾病的诊断及治疗提供了极大的帮助,因此本文总结了近年来国内外相关研究,并对CBDS的最新影像学诊断及治疗进行分析。

“诸病通用药”的体例构建及辨治模式探析

《本草经集注》序录中的“诸病通用药”以其独特的“病-药”纲目体例及其临床实用性,受到医家追捧推崇,而被后世本草学著作和方书收录及发挥,为“专病专方”“专病专药”的研究与发展奠定了基础。陶弘景以《神农本草经》之“大病之主”为基础框架,以《伤寒杂病论》之方药为参考,以自身及他医用药经验为扩充创建了“诸病通用药”体例,将当时具有代表性的病症与药物主治之长进行联系、归纳和总结,创建了“病-药”纲目体例。“诸病通用药”体例的构建开辟了“专病专方”“专病专药”的先河,为临床辨治提供新的组方思路。

内镜下CCEST微创干预治疗胰胆管合流异常患者35例分析

背景胰胆管合流异常(pancreaticobiliary maljunction,PBM)患者的共同通道(common channel,CC)过长导致Oddi括约肌的作用不直接影响到胰胆连接处,继而胰液和胆汁相互反流,造成胆道或胰腺的各种病理改变.探索内镜下微创缩短胰胆管CC通道在PBM中的应用及其机制变得尤为重要,为患者提供又一个治疗的技术选择.目的探讨经内镜下十二指肠乳头括约肌共同通道切开术(endoscopic common channel sphinctertomy,CCEST)微创干预治疗PBM患者的临床效果及安全性.方法观察分析CCEST内镜下微创干预治疗的35例PBM患者,其中BP型19例、PB型16例,复杂型0例.35例患者均行经内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)下CCEST并分析内镜下微创干预治疗对PBM患者的影响作用及并发症等情况.结果35例PBM患者中,男性12例,女性23例,平均年龄为(46±26.38)岁(3岁-89岁).所有患者均给予内镜下CCEST,以缩短共同通道.35例PBM患者中合并胆、胰管结石患者18例(51.43%),14例患者首次ERCP取石成功,成功率为78%(14/18).ERCP微创干预治疗术后1 wk,35例患者中血清生化、C-反应蛋白(C-reactive protein,CRP)指标及胆汁淀粉酶较术前均明显下降(P<0.05).5例患者出现轻度ERCP术后胰腺炎,经对症治疗后均未出现术后出血、消化道穿孔和重症胰腺炎等严重并发症.经过对35例患者(22.05±10.67)mo的随访,其中1例术后确诊胆管癌而行外科手术;有4例患者因结石复发再次行ERCP治疗,也取得满意疗效.治疗总有效率为88.6%(31/35).结论PBM起病较隐匿,ERCP可协助明确PBM诊断.CCEST通过缩短胆胰管汇合部共同通道,早期改善PBM患者胆胰管引流,是内镜微创治疗PBM患者的有效安全方法.

刍议道路桥梁工程的常见病害与施工处理技术

为减少道路桥梁工程中的各种常见病害,对常见病害与施工处理技术进行了总结与分类,在此基础上提出了4项降低道路桥梁工程常见病害的措施。通过在道路桥梁工程中应用这些措施,其常见病害状况得到了显著改善,说明所提措施可以有效改善道路桥梁工程的常见病害问题。

化工装置压力容器常见故障原因及处理

在化工生产中,压力容器是必不可少的设备之一。压力容器的主要功能是储存、输送或者处理化学工业生产中产生的易燃易爆、有毒有害物质。压力容器的使用安全不仅关系到人民群众生命财产安全,而且直接关系到国家经济的发展和社会的稳定。因此,在化工装置生产中必须加强对压力容器的维护和管理,降低因压力容器故障而造成的生产安全事故,保证化工生产顺利进行。基于此,从连接、腐蚀、泄漏、振动、变形等几个方面出发,详细阐述化工装置压力容器常见故障原因及处理策略,以期能够为相关从业工作者提供一些必要的参考。

天然气管道运行中常见设备故障及处理对策

针对天然气管道运行中的设备安全问题,本次研究首先对天然气管道运行中的常见设备故障进行分析,在此基础上,开展天然气管道运行中的常见设备故障处理对策研究,为提高天然气管道运行中的设备可靠性奠定基础。研究表明,在天然气管道运行的过程中,提高设备运行的可靠性有利于保障能源的顺利供应,天然气管道运行中的常见设备故障问题包括焊接问题、过滤器故障、管道腐蚀、阀门失效以及压缩机震动等。因此,需要从强化管道质量控制、强化管道阴极保护、定期开展过滤器和阀门维护、提高焊接质量以及压缩机震动处理等角度出发,采取多项有效措施,全面提高设备运行的可靠性以及安全性。

石油工业废水处理常用工艺研究

随着石油工业的不断发展,其排放废水带来的环境问题引起了社会广泛关注。虽然石油工业废水处理工艺技术非常多,但是不同工艺技术在处理废水方面也有所差异,需要在了解实际情况后慎重选择,只有这样才能取得理想的废水处理效果。本文基于石油工业废水的特点及危害,对废水处理常用工艺进行细致阐述,并从加强废水了解、选择合适工艺、加强联合应用等方面入手,提出几点废水处理工艺注意事项,以供参考。

谈道路与桥梁工程的常见病害及处理技术

随着城市化进程的加快和交通网络的不断完善,道路与桥梁工程在城市和乡村建设中占据了越来越重要的地位。由于长期的使用和不当的维护,许多道路与桥梁工程逐渐出现各种病害,严重影响了交通安全和通行效率,对于经济社会的发展造成了严重的制约。同时,面对日益严峻的气候变化和自然灾害,如地震、洪水等,道路与桥梁工程的稳定性和抗灾能力也面临着严峻的挑战。因此,对道路与桥梁工程的常见病害进行深入研究,探索有效的处理技术和措施,提高工程的抗灾能力和使用寿命,已成为当前工程领域的研究热点和实践需求。

道路与桥梁工程的常见病害及处理技术研究

随着城市化进程的加快和经济水平的提高,道路与桥梁工程的建设和维护日益成为社会发展的重要课题。长期以来由于设计、施工、维护等环节存在的种种问题,导致了道路与桥梁结构出现了各种病害。这些病害不仅直接影响了道路与桥梁的使用功能,还可能对行车安全和交通效率造成严重威胁。因此,对道路与桥梁工程中常见病害及其处理技术进行深入研究,对于提高道路与桥梁结构的安全性和可靠性,维护交通运输的顺畅和安全,具有重要的现实意义。